Elobixibat Outperforms Prucalopride in Refractory Functional Constipation: Study
In patients with functional constipation unresponsive to first-line treatment, elobixibat provided better bowel movement response, greater symptom relief, and improved quality of life compared with prucalopride. These findings suggest elobixibat may be a more effective option for patients with treatment-refractory functional constipation. The study was published in the journal of Alimentary Pharmacology and Therapeutics by Omesh G. and colleagues.
A comparison of the efficacy and safety of elobixibat and prucalopride was conducted by conducting a multicentre prospective pragmatic trial, which employed blinding of the outcome assessor. The participants recruited for the study were adults suffering from FC, based on the Rome IV criteria, who had failed to respond adequately or were resistant to first line laxative therapies.
After a standard run-in period to define their bowel movements, the patients were randomly assigned to either elobixibat or prucalopride therapy for eight consecutive weeks. The primary end point of the study was the attainment of a sustained CSBM response, which was defined as having at least three CSBMs per week with a difference of one additional CSBM above the baseline level for six out of the eight weeks of treatment.
Key findings:
- This clinical trial included a total of 214 patients (elobixibat, n = 108; prucalopride, n = 106) having an average age of 50.8 ± 17.4 years with 62.6% of males.
- The sustained CSBM response rate was statistically more prominent in case of elobixibat (55.6%) compared to prucalopride (33.9%; p = 0.024), indicating a clear superiority.
- Although both of the medicines were effective in increasing the frequency of the bowel movements and improving the consistency of the stools, there were some statistical advantages in terms of burden reduction for the case of elobixibat (straining, p < 0.001; abdominal discomfort, p = 0.005; abdominal bloating, p = 0.011).
- The increase in the QoL score among patients under the use of elobixibat was statistically greater (p = 0.009) than that of patients under prucalopride.
This prospective, head-to-head study demonstrates that elobixibat is more clinically effective and provides better relief of symptoms and improvement in quality of life than prucalopride in the management of functional constipation unresponsive to first-line treatments. Elobixibat has succeeded in demonstrating its superiority by exhibiting a 55.6% response rate for CSBM along with significant reduction of straining, bloating, and abdominal discomfort.
Reference:
O. Goyal, M. K. Goyal, B. Singh, et al., “ Elobixibat Versus Prucalopride in Functional Constipation: A Prospective Comparative Effectiveness Study,” Alimentary Pharmacology & Therapeutics (2026): 1–12, https://doi.org/10.1111/apt.70828.
